Active NPI
Christopher P Birdsall, MD
- Urology Physician
- Peabody, MA
National Provider Identifier
1770511586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 55899
- Practice address
- 1 Essex Center Dr
Peabody, MA 01960-2901 - Phone
- (978) 538-4180
- Fax
- (978) 538-4148
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 55899 | MA | Primary |
Addresses
Primary practice location
1 Essex Center Dr
Peabody, MA 01960-2901
Mailing address
1 Essex Center Dr
Peabody, MA 01960-2901
Phone (978) 538-4180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3050041 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55899 | MA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group, Inc | Current | Accepting new patients | |
| Steward Medical Group, Inc | Current | Accepting new patients | |
| Merrimack Valley Health Care Group | Past | Accepting new patients |
Locations
11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442
140 Lincoln Ave
Haverhill, MA 01830
Phone (978) 374-2000
100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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-
- Specialist
- Brighton, MA
- NPI 1356654495
-
- Hospitalist Physician
- Haverhill, MA
- NPI 1679679989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1770511586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ESSEX CENTER DR",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602901",
"telephone_number": "978-538-4180",
"fax_number": "978-538-4148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ESSEX CENTER DR",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602901",
"telephone_number": "978-538-4180",
"fax_number": "978-538-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRDSALL",
"first_name": "CHRISTOPHER",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MA",
"license": "55899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3050041",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.